Adaptive servo-ventilation did not significantly improve estimated glomerular filtration rate compared to standard medical therapy in patients with heart failure.
Meta-Analysis (n=427)
Does Adaptive Servo-Ventilation (ASV) improve renal function in patients with heart failure?
A meta-analysis of retrospective cohort studies found no statistically significant improvement in estimated glomerular filtration rate with the use of adaptive servo-ventilation compared to standard therapy in patients with heart failure.
Abstract Background Adaptive servoventilation (ASV) delivers pressurized air through tubing and a mask, specializing in measuring breathing patterns and providing dynamic, breath-by-breath adjustments of inspiratory pressure support (IPS). It also utilizes an auto-backup rate to normalize the breathing rate in relation to a predetermined target. Several studies highlight the benefits of ASV and its positive impact on cardiac function in patients with heart failure (HF). While a few studies have reported improvements in renal function among HF patients using ASV, there is limited research on this topic. We aim to investigate the effectiveness of ASV in enhancing renal function in HF patients. Methods We systematically searched five databases for retrospective cohort studies reporting baseline and follow-up renal function parameters, including estimated glomerular filtration rate (GFR) and creatinine. Data were pooled using random-effects models and expressed as mean differences (MD), risk ratios (RR), or logit-transformed proportions with 95% confidence intervals (CI). Heterogeneity was assessed with I² statistics. Review Manager v5.4.1 was used for statistical analysis. Results A total of six studies involving 427 patients with heart failure (HF) were included in the analysis. Three studies compared adaptive servo-ventilation (ASV) with standard therapy and medical therapy alone, involving 264 patients, used for meta-analysis. The other three studies evaluated baseline versus follow-up data within the same cohort of patients using ASV. The mean age of individuals in the ASV group was 71.4 years, while the mean age in the non-ASV group was 71.9 years. The average number of males in the ASV group was 33, compared to 28 in the non-ASV group. The baseline estimated glomerular filtration rate (eGFR) for the ASV group was 46.95 ml/min/1.73 m², while the non-ASV group had a baseline eGFR of 50.3 ml/min/1.73 m². Upon analysis, the improvement in eGFR for the ASV group was not found to be statistically significant, as the standard mean crossed the midline. Conclusion We analyzed three studies to examine the improvement of renal function in heart failure (HF) patients using Adaptive Servo-Ventilation (ASV). The analysis was limited by the small number of subjects in these studies; however, individual studies demonstrated a significant improvement in estimated glomerular filtration rate (eGFR) with the use of ASV. This suggests the potential for ASV in treating HF patients, opening up new avenues for future research on its effects in patients with sleep disorders. This abstract is funded by: None
Bhatt et al. (Fri,) conducted a meta-analysis in Heart failure (n=427). Adaptive servoventilation (ASV) vs. Standard therapy and medical therapy alone was evaluated on Improvement in estimated glomerular filtration rate (eGFR). Adaptive servo-ventilation did not significantly improve estimated glomerular filtration rate compared to standard medical therapy in patients with heart failure.